Li Jing, Gao Wei, Zhu Ji-Min, Zuo Wei, Liu Xiang
a Department of Public Health and General Medicine , Anhui University of Chinese Medicine , Hefei , Anhui , China.
b Department of Pediatric Surgery , Anhui Provincial Children's Hospital , Hefei , Anhui , China.
J Matern Fetal Neonatal Med. 2018 Oct;31(20):2742-2747. doi: 10.1080/14767058.2017.1355361. Epub 2017 Jul 27.
To analyze the clinical and epidemiological features of patients with infantile hypertrophic pyloric stenosis (IHPS) so as to provide scientific evidence for diagnosis and prevention of IHPS.
We performed a retrospective study of infants with IHPS diagnosed from 2012 to 2015 at Anhui Provincial Children's Hospital. Demographic characteristics and clinical data were collected.
Three hundred four patients (264 males and 40 females) were studied, of which 94.7% were full term and 75.7% were bottle fed or mixed fed; 16.8% of the patients had other congenital malformations in combination with IHPS. The proportion of IHPS cases with hyponatremia, hypokalemia, and hypochloremia was 18.4%, 12.5%, and 53.9%. A negative correlation was found between duration of disease and serum electrolytes. The mean pyloric muscle thickness, pyloric length, and diameter were 4.8 ± 0.7 mm, 19.4 ± 2.5 mm, and 13.3 ± 1.8 mm, respectively. There were significant differences in muscle thickness, pyloric length, and diameter between short (≤14 d) and long (>14 d) durations of disease. All patients underwent pyloromyotomy, and postoperative recovery was good.
IHPS occurs mainly in male, full-term, bottle-fed or mixed-fed infants. Patients with long duration of disease were more likely to develop electrolyte disorder and thicker muscle layer. More attention should be paid to early discovery and diagnosis, which will help to improve the curative effect and prognosis of IHPS.
分析婴儿肥厚性幽门狭窄(IHPS)患者的临床及流行病学特征,为IHPS的诊断和预防提供科学依据。
对2012年至2015年在安徽省儿童医院诊断为IHPS的婴儿进行回顾性研究。收集人口统计学特征和临床资料。
共研究304例患者(男264例,女40例),其中94.7%为足月儿,75.7%为人工喂养或混合喂养;16.8%的患者合并其他先天性畸形。IHPS患者低钠血症、低钾血症和低氯血症的比例分别为18.4%、12.5%和53.9%。病程与血清电解质之间呈负相关。幽门肌平均厚度、幽门长度和直径分别为4.8±0.7mm、19.4±2.5mm和13.3±1.8mm。病程短(≤14天)和病程长(>14天)的患者在肌肉厚度、幽门长度和直径方面存在显著差异。所有患者均接受了幽门肌切开术,术后恢复良好。
IHPS主要发生于男性、足月、人工喂养或混合喂养的婴儿。病程长的患者更容易发生电解质紊乱且肌层更厚。应更加重视早期发现和诊断,这将有助于提高IHPS的治疗效果和预后。